| NPI | 1528491438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDA FREEMAN Administrator 313-377-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MI AS630332450) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MI AS630332450) |
| 385H00000X Respite Care (Licence: MI AS630332450) | |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2013-08-14 |